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Pre-planning goes a long way

BY ROBERT KURTZ | NOVEMBER-DECEMBER 2018

In August 2017, Mississippi Valley Surgery Center in Davenport, Iowa, began work on a multi-million-dollar addition and renovation. One year later, the project is going “relatively smoothly,” says Michael Patterson, RN, ASCA Board member and the ASC’s president and chief executive officer.

Focus on communication and collaboration and catch potential problems early

BY ROBERT KURTZ | NOVEMBER-DECEMBER 2018

A significant focus on ASC expense management is directed toward labor costs, and rightfully so, considering they are a large piece of a surgery center’s overall spend, says Stephanie Martin, CASC, vice president of operations, clinical, for Westchester, Illinois-based ASC management and development company Regent Surgical Health.

Back up your data and develop a business continuity plan

BY ROBERT KURTZ | OCTOBER 2018

Even the most well-designed machines eventually fail. That includes the computers, servers and any other information technology (IT) in your ASC. Do you have a plan in place to respond when this day comes?

Join state associations and participate in benchmarking and National Advocacy Days

BY ROBERT KURTZ | SEPTEMBER 2018

A 2013 study of Medicare data by research scientists at the University of California-Berkeley found that in just four years, between 2008 and 2011, ASCs saved the Medicare program and its beneficiaries $7.5 billion. In 2011 alone, they report, the savings to Medicare and its beneficiaries totaled $2.3 billion.

It is a good time to be a seller of an ASC, says Glenn Prives, an attorney at the law firm of McElroy, Deutsch, Mulvaney and Carpenter in Morristown, New Jersey. “Numerous parties are interested in acquiring well-run ASCs these days. Hospitals are shopping, private equity firms are hungry for deals and management companies are looking to expand their portfolios.”

A company shares its successful pain management program

BY ROBERT KURTZ | SEPTEMBER 2018

When HealthCrest Surgical Partners, an Edmond, Oklahoma-based ASC management company, set out in 2017 to build comprehensive total joint replacement programs at its two Maryland ASCs the team decided it also wanted to develop a supporting opiate-sparing pain management program that delivered excellent pain relief. HealthCrest manages Frederick Surgical Center in Frederick, Maryland, and Cumberland Valley Surgery Center in Hagerstown, Maryland.

Learn their communication styles and speak their language

AUGUST 2018

While the generation an individual is born into cannot paint the entire picture of a person’s attributes and attitudes, it can provide insight for ASC leaders, says Margaret Chappell, RN, CASC, senior vice president of operations for ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.

Stay on top of your paperwork, perform drills and collaborate with your local authorities

AUGUST 2018

Do not think of complying with emergency preparedness requirements as a regulatory burden, says Kris Kilgore, RN, administrative director at Surgical Care Center of Michigan in Grand Rapids, Michigan. Rather, think of it as an opportunity.

Effective communication is key

AUGUST 2018

If you want your ASC to provide a better experience for its patients and physicians, focus on ways to get the most out of your staff, says Anne Hargrave-Thomas, chief executive officer of OakLeaf Surgical Hospital in Altoona, Wisconsin, and vice president of operations for Surgery Partners, a nationwide operator of surgical facilities based in Nashville, Tennessee.

One World Surgery provides continuum of care to patients globally

JUNE-JULY 2018

One World Surgery in Chicago, Illinois, a nonprofit, partners with communities, health care providers and leaders in health care to deliver surgical services globally. ASCA has joined hands with the organization to help fulfill its mission. Below is an excerpt from an interview with Claire Cunningham, executive director of the organization.

Keep ADA requirements in mind

JUNE-JULY 2018

Paralyzed patients rarely come into Reading Hospital SurgiCenter at Spring Ridge in Reading, Pennsylvania, says Brandi Reisch, RN, a perioperative nurse at the ASC. That, however, does not mean the ASC is any less prepared to meet their needs.

Post your ASC’s surgery prices online

“There was a change in the tide of the insurance market,” he says. “The Affordable Care Act marketplace and employers started offering higher deductible plans. When patients had a $250 or $500 deductible, surgery was affordable, regardless of the type of procedure. Then deductibles started to rise sharply.”

The credential is a seal of quality that demonstrates commitment to the ASC community, employers say

JUNE-JULY 2018

Different people take the Certified Administrator Surgery Center (CASC) examination for different reasons. ASC employers, however, say that to them the credential stands for one thing: validation that the credential- holder has mastered the skills that an ASC administrator needs.

Boost collections with transparency and up-front payments

MAY 2018

Depending on specialty, geography, payer mix and technology, the critical components of an ASC revenue cycle can change, says Lindsay Miller, executive vice president of operations at National Medical Billing Services in St. Louis, Missouri. “The ASC revenue cycle is nuanced because of its complexity in all of these areas. Each ASC faces its own set of challenges,” she says.

Expand, invest in new technology and market your brand

MAY 2018

The future of ophthalmology in ASCs looks bright, says George Violin, MD, board-certified ophthalmologist and one of the founding principals of ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.

Educate yourself, develop relationships and act quickly on denials

MAY 2018

Whether your ASC is in- or out-of-network with a payer, payment denials, payment delays and underpayments are inevitable, says Brian Hufford, health care attorney with the law firm of Zuckerman Spaeder in New York, New York.

The Certified Ambulatory Infection Preventionist credential is now available

MAY 2018

Infection preventionists in ASCs have their own certification program with the official launch of the Certified Ambulatory Infection Preventionist (CAIP) credential in January. This credential represents the culmination of extensive planning over several years, says Gina Throneberry, RN, CASC, executive director of the Board of Ambulatory Surgery Certification (BASC), which administers the CAIP exam.

Expand your ASC network, knowledge and skills at ASCA 2018

APRIL 2018

Where can you find thousands of your peers, ASC industry leaders, cutting-edge technology, the Green Monster, chowder and duck tours all in one place? Boston, Massachusetts, of course, between April 11 and 14, when ASCA 2018 convenes at the Hynes Convention Center. Need some more reasons why you need to be at this meeting? Read on.

How to protect your patients from paying out-of-network prices

APRIL 2018

Over the last several years, patients have been bearing the brunt of the first dollars coming off the top for their care, says Stanford Plavin, MD, ASCA Board member, an anesthesiologist and owner of consulting firm Technical Anesthesia Strategies and Solutions in Atlanta, Georgia. “As insurance plans have transitioned from low co-pays and low deductibles with good out-of-network benefits to higher co-pays and higher deductibles with little to no out-of-network benefits, patients are receiving what they perceive as inordinate bills. They might not have been previously privy to these bills, but they have essentially been around all along. That is where the ‘surprise’ comes in.”

Know the current standards and follow established best practices

APRIL 2018

In 2014, the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Florida, conducted its first annual safety culture survey. It asked the employees to rank the ASC’s performance in areas including safety priority within the facility, safety as part of the ASC’s ongoing agenda, accountability, issues corrected, teamwork and training.

Proceed with caution for best results

APRIL 2018

An electronic medical record (EMR) system can be a valuable tool in helping ASCs improve their billing performance, says Nanette Reintges, founder and principal consultant at Finance and Information Technology Performance Strategies, a consulting firm in Odenton, Maryland. It is vital, however, that use of the EMR does not streamline documentation to the point where potential problems can occur, she cautions.

Groundwork laid for future success

MARCH 2018

Last year was an important year for the ASC community, as ASCA and its members achieved several beneficial policy changes through steadfast federal and state advocacy efforts. ASCA is optimistic about 2018 and, with its members, continues to work with Congress, regulatory agencies and state legislatures across the country to ensure ASCs are represented as policy decisions are made.

ASCA’s Advocacy Fund helps make sure ASCs get fair legislation

MARCH 2018

ASCA created its Advocacy Fund as a way to solicit support from the ASC community and help communicate its legislative and regulatory agenda to federal and state policymakers. In particular, the fund was created to garner support from the many companies that sell products and services to ASCs and, therefore, benefit from a thriving ASC model.

Convalescent centers, skilled nursing facilities or home care?

MARCH 2018

As more complex procedures move to the outpatient setting, ASCs should be looking at where patients can receive the best post-acute recovery care, recommends Rebecca Craig, RN, CASC, ASCA Board president and chief executive officer of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colorado.

Meet your members of Congress and advocate for your ASC in Washington, DC

MARCH 2018

More than 5,600 Medicare-certified ASCs provide care to patients across the US. Despite the expanded access to top-quality care that ASCs offer and the billions of dollars ASCs save patients, Medicare and private insurers each year, many elected officials do not fully understand the role ASCs play in health care.

Strategies for success lie in pre- and postop care

FEBRUARY 2018

Arthritis and spine- and backrelated conditions in adults aged 18 and older will grow from 54 million in 2014 to 63 million by 2020 and 78 million by 2040, according to the Centers for Disease Control and Prevention (CDC).

Share basic information and encourage questions

FEBRUARY 2018

ASC staff typically have limited time to spend with patients. This makes it imperative for staff to take advantage of every moment available to provide critical education to patients, says Missy Soliz, RN, quality and risk manager for Mississippi Valley Surgery Center and Mississippi Valley Endoscopy Center in Davenport, Iowa. “We must also do so without overwhelming them or talking over their heads,” she says.

More foot cases are migrating into the ASC setting

FEBRUARY 2018

Developments over the past few years have made this a particularly exciting time for outpatient foot surgery, says Scott VanValkenburg, MD, foot and ankle surgeon at Upstate Orthopedics Ambulatory Surgery Center in East Syracuse, New York.

Where ASCs stand in the business of health care

JANUARY 2018

Three experts share their view on the future of the ASC industry and what surgery centers can ep[axpect to see this year. While ASCs are poised to grow and evolve, especially, with more higher acuity cases moving into the ASC setting, cyber security remains a threat.

Reduce risk with understanding

JANUARY 2018

Although rare, surgical fires continue to occur in health care facilities. Their prevention must be an ongoing area of focus for ASCs, says Mark Bruley, vice president of accident and forensic investigation for ECRI Institute, a Plymouth Meeting, Pennsylvania-based organization that researches approaches to improving patient care.

What ASCs need to know about FDA 510(k)

NOVEMBER-DECEMBER 2017

While ASCs have no role in the US Food & Drug Administration’s (FDA) pre-market notification 510(k) medical device clearance process, it is imperative that they understand what the clearance does and does not include and cover, says Barbara Ann Harmer, president at MedAssist Consultants, a provider of medical and surgical consulting services based in Gainesville, Florida.

Plan ahead, take your time and do your research before making a purchase

NOVEMBER-DECEMBER 2017

Price is not the only factor to take into consideration when purchasing a new piece of equipment, but it is an important one, says Sherrie Landry, materials manager for Bayou Region Surgical Center in Thibodaux, Louisiana. “You really want to make sure you make the right purchase the first time.”

Invest in OR technology

NOVEMBER-DECEMBER 2017

If you want to keep your surgeons happy, give them the surgical technology they want, says Brian Brown, regional vice president of operations for AmSurg Corporation, an ASC management and development company based in Nashville, Tennessee.

Responsibilities of ASCs

OCTOBER 2017

The opioid crisis presents both a challenge and an opportunity for ASCs, says Amy Mowles, president and chief executive officer of Edgewater, Maryland-based Mowles Medical Practice Management, an ASC regulatory and development company.

Looking to grow your case volume while accommodating the needs and wishes of patients from within— and even potentially outside—your community? Consider offering a cashpay program, say ASC managers who are already offering this option.

“On time,” according to the definition used in Medicare’s ASC Quality Reporting (ASCQR) Program’s ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing measure meant these antibiotics were initiated within one hour prior to the time of the initial surgical incision or the beginning of the procedure, or two hours prior if Vancomycin or fluoroquinolones were administered.

Three accrediting agencies explain upcoming modifications in their standards

SEPTEMBER 2017

The Accreditation Association for Ambulatory Health Care of Skokie, Illinois, the American Association for Accreditation of Ambulatory Surgery Facilities of Gurnee, Illinois, and The Joint Commission of Oakbrook Terrace, Illinois, described the upcoming changes in their standards for ASC Focus. Learn what to expect from your survey experience, the steps you need to take to stay on top of your game and how to comply with the changed standards.

In the absence of CEHRT, ASCs adapt to reach clinical integration

BY SAHELY MUKERJI | SEPTEMBER 2017

If an ASC needs to participate in the continuity of care across a surgical episode, it needs to have an IT system that speaks to a physician partner’s electronic health records (EHR), says Roy Georgia, partner in the ASC Division of ICE Technologies, headquartered in Pella, Iowa. “Herein comes the need for interoperability,” he says. “With a lot of consolidation in the ASC software space, there is going to be more standardization and increased adoption of EHR products. With that, there will be a more specific need for interoperability.”

Look beyond the price tag, choose carefully

ASCs, today, have their choice of many different types of information technology (IT) systems and many different suppliers. The IT systems have tremendous potential to help ASCs achieve their growth objectives, says Paul Davis, chief executive officer and president of Amblitel, a provider of ASC accounting and back-office services based in Louisville, Colorado.

Stay on track with an ongoing, active process

BY ROBERT KURTZ | SEPTEMBER 2017

The primary focus for everything that happens at the Orthopedic Surgery Center of Orange County in Newport Beach, California, is patient safety, says Karen Ollila, the ASC’s operations manager. Peer review, she says, is a critically important part of that focus.

Staff training is key

BY ROBERT KURTZ | SEPTEMBER 2017

An ASC that wants to capitalize on its investment in information technology (IT) has to invest in training staff to operate the new system, says Matt Petty, senior vice president of IT for Surgery Partners, a nationwide operator of surgical facilities based in Nashville, Tennessee.

Educate yourself to avoid adverse outcomes and litigation

BY SAHELY MUKERJI | AUGUST 2017

The term “scope of practice” has different definitions in policy and professional documents, which is why it is critical to know how your state’s regulations define the term, says Debra Stinchcomb, RN, CASC, consultant with Progressive Surgical Solutions in Fayetteville, Arkansas.

Develop a long-term plan, be responsive to your doctors’ needs and make sure staff is happy

BY ROBERT KURTZ | AUGUST 2017

Between November 2014, when Jennifer Morris became the administrator of Surgicare of Wichita in Wichita, Kansas, and May 2017, the ASC added 26 physicians across seven specialties. She says that part of the reason for that is because she is always working on physician recruitment since it is vital to sustaining an ASC.

Check accreditation, state registration and licensure, and FDA track record

BY ROBERT KURTZ | JUNE-JULY 2017

Compounding pharmacies can play an important role in supplying ASCs with medications they need to provide patient care, says Sharon Johnson, RN, CASC, senior vice president of operations for ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.

‘Scopes for Hope’ at Surgery Center of Farmington sees early success

BY ROBERT KURTZ | JUNE-JULY 2017

Last year was a difficult year for the gastroenterology service line at the Surgery Center of Farmington in Farmington, Missouri, says Cindy Young, RN, CASC, the ASC’s administrative director. After starting the year with five gastroenterology physicians, only one remained at the end.

How to create and maintain a social media site

BY SAHELY MUKERJI | MAY 2017

More than 3 billion people use the Internet and more than 2 billion of those users have active social media accounts, according to an August 2016 Hootsuite column. Given the widespread use, social media is no longer optional for businesses, says Kelly David, director of marketing and public relations at Spectrum Medical Group in Portland, Maine. “The more we become patient and customer focused, the more important a tool social media becomes to connect.”

Take advantage of more than 60 educational sessions and advocate for your ASC

BY ROBERT KURTZ | MAY 2017

At a time when Washington, DC, is under the world’s microscope, it seems fitting that ASCA is bringing the ASC community into the heart of the action at ASCA 2017, May 3–6, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.

“Attending an ASCA meeting continues to be an unparalleled opportunity for all attendees, regardless if it is your initial meeting or your 25th,” says Jo Vinson, CASC, director of integration management for Deerfield, Illinois- based Surgical Care Affiliates.

Train staff to maintain data security and privacy

BY ROBERT KURTZ | MAY 2017

Even in an ASC with great information technology infrastructure, human error can open the door for cyber criminals, says Tracy Rubino, privacy officer of ambulatory surgery centers for not-for-profit health system Sutter Health in Sacramento, California. In fact, Verizon’s 2016 Data Breach Investigations Report cites human error as one of the leading causes of health care cyber security incidents.

Reduce your risk and the cost of protection

BY ROBERT KURTZ | MAY 2017

ASCs need to prepare for the possibility of a data breach and be ready to respond if it happens, says Michael Wells, chairman of Hylant of Indianapolis, an insurance brokerage and risk management solutions provider in Indianapolis, Indiana.

What ASCs need to be on the lookout for

BY SAHELY MUKERJI | APRIL 2017

Coding modifiers—usually two digits—can increase or decrease reimbursement and cause claims not to be paid properly or denied if used incorrectly or not used when necessary. “Modifiers are added to the main procedure code to signify that the procedure has been altered by a distinct factor,” says Stephanie Ellis, RN, president of Ellis Medical Consulting Inc. in Franklin, Tennessee. “Modifiers are accepted by most payers.”

Streamline production, eliminate waste and improve efficiency

BY ROBERT KURTZ | APRIL 2017

For an ASC striving to bring about improvements throughout the facility, applying Lean Six Sigma principles can be an effective method to achieve desired results, says Erin Huston, RN, the Lean Six Sigma Black Belt continuous improvement specialist for The Urology Group and its ASC, The Urology Center, in Cincinnati, Ohio.

Surgery centers should seize the opportunity

BY ROBERT KURTZ | APRIL 2017

Regardless of the changes that will be made to the US health care system in the coming years, at least one thing seems to be certain, says Gregory Horner, MD: Value-based care is here to stay. Horner, an ASCA Board member, works as a managing partner at HealthPoint Ambulatory Surgery Company, an ASC management and development company in Newbury Park, California.

Skilled nursing facilities would work with surgery centers

BY ROBERT KURTZ | APRIL 2017

Andy Whitener is the chief executive officer and administrator of Gainesville Surgery Center in Gainesville, Georgia, an affiliate of Surgical Care Affiliates. Write him at Andy.Whitener@SCASurgery.com.

Avoid contaminants with careful testing and vigilance

BY ROBERT KURTZ | MARCH 2017

What you do not know about your ASC’s water could harm patients and damage devices, says Barbara Ann Harmer, RN, director of clinical services for Innovative Sterilization Technologies in Dayton, Ohio, a company that developed and markets a sealed sterilization container system.

Reduce costs, increase value, maintain choice

BY SAHELY MUKERJI | MARCH 2017

Knowledge is power when it comes to getting a good price on implants, says Tim Burney, founder and chief executive officer of Advantien in Greenwood Village, Colorado. “You need to know the market and your alternatives,” he says. “Do not accept that you cannot get the same price as the hospitals. You can, believe me, you can.”

Be cognizant of financial obstacles and cultural differences

BY SAHELY MUKERJI | MARCH 2017

Running an ASC in a low-income area is fraught with risks, delays in payment, demands from the Department of Health and the fire department, and other adverse factors, says Roy Bejarano, president of Frontier Healthcare in New York, New York. “It is a fragile and delicate situation,” he says. “ASCs, however, are the smarter health care option for low-income areas because they offer high-quality care at a lower cost than hospitals and are more specialized than hospitals.”

Effective communication, drills and working with your local organizations are key

BY ROBERT KURTZ | MARCH 2017

In a disaster, either natural or manmade, continuity of operations planning helps an ASC protect and preserve its critical infrastructure, says Lynne Bergero, project director for the division of health care quality evaluation at The Joint Commission in Oakbrook Terrace, Illinois.

ASCs that do can reduce expenses and improve contracts

BY ROBERT KURTZ | MARCH 2017

Do you know what it costs when patients are in your ASC’s operating room (OR), asks Ann Geier, RN, CASC, chief nursing officer for SourceMed, a Birmingham, Alabama-based provider of software and ASC advisory services for ASCs and other organizations. Since the OR is where an ASC generates revenue, she says, understanding the costs incurred there is an essential management tool for an ASC.

Sign up for National Advocacy Day when you register for ASCA 201

BY DANIELLE KASTER | FEBRUARY 2017

As rising costs, inadequate payment updates and the steady growth of hospital-employed physicians continue to threaten ASCs, ASCA’s ongoing efforts to promote the interests of the ASC community before the legislative and regulatory bodies that set ASC policies grow increasingly important. The success of ASCA’s advocacy efforts, however, relies on the participation of everyone in the ASC community.

If you do not know how your ASC’s revenue cycle is performing, you will not know how to improve it says Crystal Ewing, manager of data integrity for ZirMed, a provider of claims management solutions based in Louisville, Kentucky.

ASCA’s 2017 advocacy agenda

BY KRISTIN MURPHY AND KARA NEWBURY | FEBRUARY 2017

In 2017, ASCA will be working on many levels with multiple regulatory agencies and Congress to ensure that ASCs are at the table and in the conversation when federal policy decisions that affect surgery centers are made.

Meet the Government Affairs team

BY SAHELY MUKERJI | FEBRUARY 2017

ASCA’s Government Affairs Department leads ASCA’s efforts to promote the interests of the ASC community before federal and state legislative, regulatory and executive agencies. Working with state ASC associations and industry leaders, the department staff identify and analyze critical health policy issues concerning ASCs and act to enhance and protect each ASC’s ability to continue providing high-quality patient care.

These contributions ensure that the ASC message is heard in Congress

BY DANIELLE KASTER | FEBRUARY 2017

ASCAPAC is the only political action committee in Washington, DC, that represents the interests of the entire ASC community. Through the contributions it receives, ASCAPAC helps ensure that the policymakers who support and understand the importance of the ASC delivery model remain in Congress.

Drug shortages continue to be a challenge for ASCs as they impact providers with little or no warning and potentially threaten patient safety, says Norman Tomaka, clinical consultant pharmacist in Melbourne, Florida.

The numbers of community hospitals and ASCs are going in different directions

BY ROBERT KURTZ | JANUARY 2017

It is a good time to own an ASC, says Mark Weiss, an attorney with The Mark F. Weiss Law Firm, which has offices in California and Texas.

“The health care landscape is changing quickly, and ASCs look to be positioned for success,” says Weiss, the author of The Impending Death of Hospitals: Why You Must Plan Your Medical Practice’s Survival and other health care books. “The evolving hospital model is creating a growing pool of potential opportunities for surgery centers.”

What ASCs can do

BY ROBERT KURTZ | JANUARY 2017

The Centers for Disease Control and Prevention (CDC) reports that more people died from drug overdoses in 2014 than any other year on record (www.cdc.gov/drugoverdose/ epidemic/index.html). A majority of drug overdose deaths—more than 60 percent—involve an opioid. And nearly 80 Americans die daily from an opioid overdose.

Patient selection and tracking metrics under bundled care

BY SAHELY MUKERJI | NOVEMBER-DECEMBER 2016

The number of anterior cervical discectomy and fusion (ACDF) surgeries, one of the most common spine procedures performed in the US today, continues to rise as a result of the growing elderly population in the country, says Anthony L. Asher, MD, ASCA Board member, director of the Neuroscience Institute at Carolinas HealthCare System and a senior partner at Carolina Neurosurgery and Spine Associates in Charlotte, North Carolina.

Will the bundled payment model work for ASCs?

COMPILED BY SAHELY MUKERJI | NOVEMBER-DECEMBER 2016

The federal government has initiated broad adoption of bundled payment methodologies in inpatient settings including the Bundled Payment for Care Improvement (BPCI) initiative and, more recently, the Comprehensive Care for Joint Replacement (CJR) regulations. According to the Centers for Medicare & Medicaid Services (CMS) more than 500 hospitals now participate in these programs.

Prevention and backups are the best defense

BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016

Steven Sanchez, network administrator and facilities manager for Pend Oreille Surgery Center in Ponderay, Idaho, says ransomware is an issue of growing concern for his ASC. He points to the increasing number of organizations affected by this cybersecurity threat.

Train, monitor and audit

BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016

Rancho Bernardo Surgery Center makes medication preparation a constant area of focus, says Stephanie McIntosh, RN, administrator for the San Diego, California-based ASC. “Keeping it at the forefront of everyone’s mind is what keeps us vigilant with following regulations and proper practices.”

Avoid eight common mistakes

BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016

Social media usage has jumped nearly tenfold from 7 percent in 2005 when the Pew Research Center began tracking social media usage to 65 percent in 2015, according to an October 2015 Pew Research report. Consequently, there is increasing pressure on ASCs to develop an online presence, says Charlie Leonard, a public affairs adviser based in Santa Barbara, California.

Work with your local authorities when creating your emergency preparedness plan

BY SAHELY MUKERJI | OCTOBER 2016

For Chris Bland, director of safety and security at Good Shepherd Medical Center and Good Shepherd Ambulatory Surgery Center in Longview, Texas, the definition of a disaster is when the need outweighs the resources.

“When you have an emergency or a natural disaster, your resources are overwhelmed and you need more resources than you have,” he says. “So you need help from your local police department, fire department and all other emergency responders.” Given that, it is in an ASC’s best interest to establish good relations with local authorities before disaster strikes, he says.

Make emergency preparedness a top priority in your surgery center

BY ROBERT KURTZ | OCTOBER 2016

For most ASCs, it is not a matter of if, but when they will face a disaster, says Anne Haddix, the disaster preparedness coordinator for the Indiana Federation of Ambulatory Surgical Centers and chief executive officer of Southwest Surgical Suites in Fort Wayne, Indiana. ASCs must ensure they are effectively prepared to respond when a disaster strikes, she says.

ASCA’s second generation clinical and operational program offers apples-to-apples comparison

BY ROBERT KURTZ | OCTOBER 2016

Castle Surgicenter in Aurora, Illinois, benchmarks to ensure that it is providing the best quality, safest care possible, says Patricia Darimont, RN, the ASC’s clinical director. “If benchmarking reveals an opportunity for improvement, we work to make changes,” she says.

Three new courses to be added in fall

BY SAHELY MUKERJI | OCTOBER 2016

ASCA will add three new courses to its Regulatory Training Series this fall: Hand Hygiene, Latex Allergy, and Prevention of Healthcare Associated Influenza. This addition will bring the total number of interactive courses in the series to 24, with 18 offering continuing education (CE) credits to facility learners. Current subscribers will automatically receive the new courses once they are released.

Do it quickly and make sure that it is executable

BY ROBERT KURTZ | OCTOBER 2016

Act fast, and take it seriously. That is the advice that retired Medicare surveyor and current regulatory and accreditation compliance consultant Bruce Ettinger, MD, of Santa Monica, California, has for ASCs that are required to submit a plan of correction (POC) to address deficiencies found during a Medicare survey. Ettinger is also an ASCA Board member.

The value of nursing input into ASC building design

BY ROBERT KURTZ | SEPTEMBER 2016

Whether building a new ASC or expanding an existing facility, developers would be wise to include nurses on their design team, says Stephanie Leventis, RN, vice president of development for SurgCenter Development, an ASC development company based in Pismo Beach, California.

How to assess hand hygiene and stay compliant

BY SAHELY MUKERJI | SEPTEMBER 2016

Despite years of hard work to promote and attain hand hygiene compliance in the health care setting, the industry continues to struggle to achieve goals that are set by external agencies and within the facilities themselves, says Phenelle Segal, RN, president of Infection Control Consulting Services in Delray Beach, Florida.

Dearth of trained nurses has inspired surgery centers to develop their own programs

BY ROBERT KURTZ | SEPTEMBER 2016

Declining numbers of available operating room (OR) nurses have led some ASCs to develop their own perioperative RN training programs. Examples of those programs can be found in Florida Medical Clinic’s two ASCs in Tampa, Florida, and Zephyrhills, Florida, and in the Ambulatory Surgery Center of Niagara in Niagara Falls, New York.

Talk with your patients early to ensure success

BY ROBERT KURTZ | SEPTEMBER 2016

William E. Lindeman is the president of WEL Designs PLC of Tucson, Arizona, a consulting firm for health care facility development and regulatory compliance. As a licensed architect working with health care providers since 1983, he has helped plan and design millions of square feet of ASCs, medical practice suites and other facilities.

Benefits and drawbacks

BY SAHELY MUKERJI | AUGUST 2016

In April, insurance giant Aetna won $37.4 million in a jury verdict against Bay Area Surgical Management (BASM), based in Saratoga, California. The 2012 law suit against BASM alleged that the firm recruited physicians to refer their patients for out-of-network procedures at overblown prices and billed Aetna millions of dollars fraudulently.

Anesthesia can help ASCs overcome common accreditation pitfalls

BY ROBERT KURTZ | AUGUST 2016

ASCs looking to improve their accreditation survey performance would be wise to involve anesthesia personnel in the preparation efforts, advises Thomas Wherry, MD, cofounder of Total Anesthesia Solutions, a provider of anesthesia service solutions in Ellicott City, Maryland, and a former surveyor for the Accreditation Association for Ambulatory Health Care.

Make your collections efforts successful

Collection from patients will become more challenging as the insurance plans change, says Melodie Garrobo, CASC, administrator for Golden Ridge Surgery Center in Golden, Colorado.

“The patient population became accustomed to coming into a facility, receiving care and worrying about payment later,” she says. “This used to be acceptable with most health care institutions but that was when insurance covered most of the payment. Consumers are moving to high-deductible insurance plans, which means less of the payment comes from insurance and more must come from patients. This is a new world, and ASCs must make patient collections a priority.”

Why that matters

BY ROBERT KURTZ | AUGUST 2016

In March, the US Department of Health & Human Services’ Office for Civil Rights (OCR) announced the launch of its next phase of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) audits of covered entities and their business associates. Click here for more information.

“This news should be a wake-up call for ASCs and all health care providers covered under HIPAA to take a close look at what they are doing and have in place concerning HIPAA compliance,” says Lani Dornfeld, head of law firm Brach Eichler’s Palm Beach, Florida, office and a member of the firm’s health law practice group.

Join PIH and ASCA to provide surgical services to those in need

Around the world, two billion people lack access to surgical care and many more struggle to find and pay for it, according to an article in the June 2015 issue of The Lancet.

The poorest third of the world’s population receives less than 4 percent of all surgical services, according to a June 2011 World Health Organization report. The impact is devastating on impoverished nations. And every day, Partners In Health (PIH), a global health nonprofit, headquartered in Boston, Massachusetts, strives to fight this tragedy, bringing high-level surgical care where it is most needed—from Haiti to Rwanda and around the world.

The first of its kind for ASCs

BY SAHELY MUKERJI | JUNE-JULY 2016

The Joint Commission launched its Total Hip and Knee Replacement Advanced Certification Program and began to accept applications from interested facilities on December 17, 2015. On-site reviews started on March 14, says Wendi Roberts, executive director of certification at The Joint Commission. “We are getting applications every week and currently have approximately 15 applications, including one from an ASC [as of April 15, 2016],” she says.

Use your membership to your benefit

BY SAHELY MUKERJI | JUNE-JULY 2016

While being a member of ASCA gives an ASC a broadened view of the industry, an understanding of national policies and guidelines and networking benefits on a global scale, being a member of a state association comes with its own set of benefits, says Andrew Weiss, president of the New Jersey Association of Ambulatory Surgery Centers (NJAASC) and administrator of The Endo Center at Voorhees in Voorhees Township, New Jersey.

Leaner, more efficient practices result in financial savings, improved employee recruitment and retention

BY ROBERT KURTZ | JUNE-JULY 2016

An ASC can have a positive impact on its community both inside and outside the facility, environmental experts say.

“It is important for health care providers like ASCs to practice what they preach in terms of embracing the connection between environmental and human health, to promote health and wellness for the people in their community by doing what they can to support a cleaner environment,” says Kaeleigh Sheehan, member engagement manager for Practice Greenhealth, a Reston, Virginia-based nonprofit member organization that provides environmental solutions for the health care sector.

Keep your physicians, staff and patients happy

BY ROBERT KURTZ | JUNE-JULY 2016

As health care organizations continue to compete for physicians, staff and patients, ASCs need to make themselves the facility of choice or lose to other players in the field, says Kris Sabo, RN, executive director of Pend Oreille Surgery Center in Ponderay, Idaho. “We need to be providing better customer service to our physicians, staff and patients than our competition or we could easily lose them all,” she says.

Plan now to make the most of the opportunities there

BY SAHELY MUKERJI | MAY 2016

In a year filled with change and uncertainty in health care, ASCA is offering ASC professionals a one-stop shop where they can get everything they need to manage their facility more effectively and make critical decisions that will ensure their ASC’s future success. ASCA 2016, May 19–22, at the Gaylord Texan Resort & Convention Center in Dallas, Texas, is that destination.

Effective ways to keep on top of shortages and costs

BY ROBERT KURTZ | MAY 2016

Managing her ASC’s medication inventory is not just an occasional part of the job for Cheryl Ezerskis, CASC, executive director at West Parkway Ambulatory Surgery Center in Pompton Plains, New Jersey. “I spend more time managing our inventory than I care to admit,” she says. “I have to monitor medications every day. Getting the medications we need to do our procedures is a never-ending game I have to play.”

Detection and prevention advice

BY ROBERT KURTZ | MAY 2016

Drug diversion and poor management of controlled substances in a health care facility can lead to serious consequences. This illegal transfer and use of prescription medicines could result in patient harm and fines and loss of license for an ASC.

Research, analyze and compare before you buy

BY ROBERT KURTZ | APRIL 2016

Acapital purchase mistake can have a significant financial impact on an ASC, says Jennifer Butterfield, RN, CASC, administrator of Lakes Surgery Center in West Bloomfield, Michigan. “Unfortunately, we do not have very deep pockets. If you are going to be taking on the burden of a large purchase and, with it, a large monthly payment, you need to have the cases to justify and then support that payment.”

Follow these ‘Five Habits’

BY ROBERT KURTZ | APRIL 2016

In mid-2014, Deerfield, Illinois-based surgical solutions provider Surgical Care Affiliates (SCA) set out to determine what could be done for every patient to consistently improve the patient experience. To achieve this objective, SCA formed a committee that looked at organizations and companies known for their customer service excellence, including the Cleveland Clinic, Disney and Starbucks.

New payment models promote cost-effective sites of service and patient choice

BY ROBERT KURTZ | APRIL 2016

ASCs have many reasons for replacing one piece of equipment with another. Some are under the ASC’s control, but others are not. Careful planning and the five tips that follow can help ensure that an ASC is buying wisely and help make the changes involved easier for everyone.

Sound strategies for employee termination

BY ROBERT KURTZ | MARCH 2016

While you might hope that you never need to terminate an employee, ASC leaders always need to be prepared to do so, says Damaris L. Medina, JD, a health care attorney with Michelman & Robinson, LLP, who is based in Los Angeles, California.

Follow an ASC bill on its journey to becoming a law

BY KRISTIN MURPHY | FEBRUARY 2016

ASCA and ASCs across the country are on the precipice of a major legislative victory this year: the adoption of the Electronic Health Fairness Act. In 2015, the US House of Representatives and the US Senate unanimously passed slightly different versions of the act which, if enacted, will provide relief to ASC physicians who face penalties due to Medicare’s meaningful use requirements tied to electronic health records (EHR) systems. As this article goes to press, Congress is reconciling the two versions of the bill; the reconciled bill must be passed before it can be signed into law by President Barack Obama.

How the regulatory requirements that apply to your ASC are created and changed

BY STEVEN SELDE | FEBRUARY 2016

Just as there is a legislative process that all bills must go through to become law [see page 10], there is a regulatory, or rulemaking, process that determines the rules that will be adopted to enforce new laws. Most laws contain language that helps to identify which federal agency will set those rules. Often, the laws also identify specific areas that the rules should address.

Do your research before you buy

BY ROBERT KURTZ | FEBRUARY 2016

ASCs have many reasons to purchase an electronic medical records (EMR) system. One is that health care providers of every kind are rapidly adopting electronic records, says Cindy Klein, vice president and chief medical information officer of United Surgical Partners International, an owner, operator and developer of ASCs and short-stay surgical hospitals nationwide based in Addison, Texas.

Stand up for your center and the work that you do for your community

BY DANIELLE KASTER | FEBRUARY 2016

For more than 40 years, ASCs have provided millions of Americans with high-quality, cost-efficient surgical care, yet many legislators are unaware of their work and how they have transformed the outpatient experience. While ASCA continues to advocate for ASCs and serve as the voice of the ASC community, there is no substitute for individual ASC leaders and staff who lobby their legislators as constituents.

How to handle business with the company going under

BY ROBERT KURTZ | JANUARY 2016

Organizations often use bankruptcy as a financial tool to upright their financial stability, says Timothy Walsh, JD, international head of the restructuring and insolvency practice in the law firm of McDermott Will & Emery, who practices out of the firm’s New York office. “All bankruptcy means is your inability to pay your debts as they become due. That is the only requirement you need to be able to file.”

To be successful, be proactive in pursuing alignment strategies

BY ROBERT KURTZ | JANUARY 2016

Under the federal budget adopted last November, hospitals and health systems are no longer able to buy ASCs, convert them to hospital outpatient departments (HOPD) and charge HOPD prices in those facilities. Even without that option, the trend toward consolidation in the US health care marketplace continues. Many are trying to determine how consolidation is affecting individual ASCs throughout the country, but the only definitive answer seems to be “It depends.”

The agency will roll out its first advanced certification program for surgery centers this year

BY SAHELY MUKERJI | JANUARY 2016

The Joint Commission is planning the launch of a new product called Total Hip and Knee Replacement Advanced Certification Program this year. The agency has been working with ASCA for the last couple of years to develop this program.

ASCA surveys also reveal small salary increases since 2012

BY ROBERT KURTZ | JANUARY 2016

ASCs across the country invest more in employee benefits and pay modestly higher salaries to nearly all staff today than in 2012, according to an analysis of data from ASCA’s recently released 2015 ASC Salary and Benefits Survey report and ASCA’s 2012 survey. The analysis also shows that while more ASCs pay bonuses to more staff, the amounts of those bonuses are slightly under those paid in 2012, the last year ASCA conducted its compensation survey. The 2015 survey results, collected from 846 participants, include data on 20 ASC job positions, employee benefits and ASC demographics.